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GPs need more training to better help support victims of bullying

GPs feel they don’t have the right training or guidance to help support children and young people who are being bullied, according to research published today.

Doctor and patient

The new study, published in the British Journal of General Practice, found that whilst GPs feel they have a major role to play in supporting the health of children and young people who disclose bullying during appointments, they feel ill-equipped to deal with the issue because of a lack of professional development opportunities and guidance on treating and managing the health consequences of bullying.

The research was carried out by Dr Vibhore Prasad as part of his postdoctoral research University of Nottingham and Dr Laura Condon and was supported by the Rushcliffe Clinical Commissioning Group NIHR Research Capability Fund. Dr Prasad is now NIHR Academic Clinical Lecturer in General Practice in the School of Population Health & Environmental Sciences and works as a GP in Nottinghamshire.

Bullying among children and young people is a major public health concern which can lead to physical and mental health consequences. Around 50% of children and young people report being bullied, with 10-14% being bullied chronically for more than six months.

Many children experience severe physical, psychosomatic and emotional health consequences, so bullying is a major risk factor for mental health problems too.

Children and young people may disclose bullying and seek help from their GP, however, there has been little research on GPs views and perceptions on their role in dealing with these disclosures.

Current guidelines from NICE make recommendations for primary healthcare professionals to be trained in the evaluation of psychosocial risk factors for bullying, with the need for physicians to be knowledgeable about the interventions available.

As part of the study, interviews were carried out with 14 GPs working in the NHS lasting between 30 and 45 minutes, exploring GPs views of disclosures of bullying by young people and their experiences of recognition, management and gaining access to specialist services.

The findings explored GPs’ views on their role in dealing with the physical and mental health consequences of bullying once it is reported and the wider societal factors that impact the scope of their role in dealing with the consequences.

The GPs saw their role as identification and management of children and young people’s associated physical and mental health consequences and to, as far as possible, put in place a network of support for them.

One of the key challenges highlighted by GPs was the short length of consultation times, which do not allow the extent of the bullying to be discussed fully. Guidelines on dealing with bullying are currently lacking, particularly with regard to identifying the contribution that bullying is making to children and young people’s presenting symptoms by asking the right questions; the different types of bullying and their impact on their health, and providing clear direction over referral pathways and specialist services available to manage mental health.

Whilst GPs are keen to help deal with the consequences of bullying, they feel constrained by time and resource. Many also felt there was a lack of clarity over what their role was.

The research also recommends that bullying requires an interdisciplinary approach so training may address needs for a range of health and education professionals.

Bullying is a key risk factor for illness in children and young people, which, if left untreated, contributes to a greater burden of health service use in adulthood. Therefore, systematic screening of vulnerable young people for bullying could potentially prevent more serious health events. However, further research would be needed to see whether this would be effective. It will be important not to add to GP’s already large workloads. Clear guidelines also need to be in place for referral services.– Dr Vibhore Prasad, NIHR Academic Clinical Lecturer in General Practice, School of Population Health & Enviornmental Sciences

Carrie Herbert MBE, Founder and President of Red Balloon Learner Centres for the recovery of Bullied Children, said "Bullying in a serious and widespread issue in schools and for many young people. Children need to have a range of adults to whom they can talk such as parents, teachers and church leaders, and doctors fit into this category of listeners well. 

“GPs are a group of professionals who meet young people and their families and are well placed to help in these circumstances. Asking the right questions, helping the young people to deal with their fears and worries and knowing how to move the concern on will provide young people and their families with another source of professional help.  It is essential that GPs are trained."

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Vibhore  Prasad

Vibhore Prasad

NIHR Academic Clinical Lecturer in General Practice